Nucleotide sequence analysis of the ORF0 region of Potato leafroll virus isolates from Tunisia.

Potato leafroll virus (PLRV) isolates from potato plants from different regions of Tunisia were investigated for the ORF0 variable region of genomic RNA using PCR, nucleotide sequencing and sequence analysis. Based on the ORF0 variable region nucleotide sequence, individual Tunisian isolates were more homologous as a group compared to the isolates originating from other parts of the world. There was no correlation between bioclimatic origin of the isolates and their ORF0 sequence. Alignment of the deduced amino acid sequences showed that the P0 protein was not much conserved. Unexpectedly, Tunisian isolates were found to be most homologous to Peruvian ones both at nucleotide and amino acid level. A phylogenetic tree, based on the P0 amino acid sequence, showed that all the PLRV isolates were located in two major clusters regardless of their geographic origin. In the second cluster, three sub-clusters could be distinguished. These results provide valuable information for molecular characterization of the PLRV isolates occurring in Tunisia.

[Five years experience with non-pulsatile flow]. / Enseignement de 5 années d'expérience avec les assistances circulatoires à flux non pulsé.

Mechanical circulatory assistances now belong to the therapeutic stock in case of advanced heart failure. Their mainspring lays on the substitution of the failing left and/or right ventricle function with a pump. The goal being to maintain or restore the system main functions. Their main indication is a bridge to transplant mechanical circulatory assistance, allowing the patient to await transplantation. However, indications for definitive implantation appear in case of transplantation counter indication, mechanical circulatory assistances already emerging as a possible alternative to transplantation. For over 10 years, we have used pulsatile flow assistances, either with pneumatic ventricles or electro-mechanic implantable left ventricles. We henceforth observe the development of a new generation of implantable assistance providing a non-pulsatile flow. These are axial pumps. We evaluated the first model, the DeBakey axial pump which became the most used axial pump worldwide. We now observe the development of other axial pumps as well as the development of new implantable centrifugal pumps.

Resection of bronchopulmonary cancers invading the left atrium--benefit of cardiopulmonary bypass.

AIMS: Cardiopulmonary bypass (CPB) for extended lung resections involving great vessels and other mediastinal organs remains controversial, especially due to CPB-related haemorrhagic and immunological issues. Here, we will retrospectively analyse the results obtained with such procedure. MATERIAL AND METHODS: Between January 1994 and February 2001, four patients underwent surgery under CPB for lung carcinoma in our department. Three patients were male and one female; mean age was 58.8 +/- 6.3 years. The patients suffered from malignant pulmonary lesions involving the left atrium (T4 or stage IIIb) - two epidermoid carcinoma, one adenocarcinoma and one large-cell carcinoma. Procedures were performed under complete CPB with aortic cross-clamping in all but one patient who underwent hypothermic ventricular fibrillation. Mean CPB duration was 86.7 +/- 26.5 min. RESULTS: There were no hospital mortalities (D30). Mean duration for assisted ventilated support was 9.5 +/- 2.5 hours, 2.5 +/- 1 days for ICU stay and 14.3 +/- 1 days for hospital stay. Operation-related complications were rare. Two patients presented with transient postoperative atrial fibrillation. Only one patient had to undergo reoperation for compressive haemopericardium drainage at D23. The mean quantity of transfused packed red blood cell packs was 2.7 +/- 1.7. Two patients survived over three years after surgery and one patient is still alive at 72 months without any recurrent symptom. CONCLUSION: In some cases of T4 lung cancer considered inoperable, CPB permits extended lung resections offering significant hope for survival at an acceptable operative risk.

Left ventricular reconstruction after resection of a large fibroma.

Cardiac fibromas are rare tumors that are histologically benign but potentially lethal because of their location. The prognosis is related to complete resection. We report the case of a 15-year-old boy who, 1 year after partial excision of a large fibroma, underwent successful complete resection through a conventional surgical approach with left ventricular reconstruction.

The passage of Potato leafroll virus through Myzus persicae gut membrane regulates transmission efficiency.

Potato leafroll virus (PLRV) is transmitted by aphids in a persistent manner. Although virus circulation within the aphid leading to transmission has been well characterized, the mechanisms involved in virus recognition at aphid membranes are still poorly understood. One isolate in our collection (PLRV-14.2) has been shown to be non- or only poorly transmitted by some clones of aphids belonging to the Myzus persicae complex. To determine where the transmission process was blocked within the aphid, three virus transmission procedures were used. PLRV-14.2 could not be transmitted, or was only very poorly transmitted, after acquisition from infected plants or from purified preparations. In contrast, it could be transmitted with more than 70% efficiency when microinjected. Therefore, it is concluded that the gut membrane was a barrier regulating passage of PLRV particles from the gut lumen into the haemocoel of M. persicae. Comparison of coat protein (CP) and readthrough protein (RTP) sequences between poorly and readily transmissible isolates showed that PLRV-14.2 differed from other PLRV isolates by amino acid changes in both of these proteins. It is hypothesized that at least some of the changes found in CP and/or RTP reduced virus recognition by aphid gut receptors, resulting in reduced acquisition and subsequent transmission of PLRV-14.2.

[Human valvular substitutes for the treatment of complex progressive endocarditis. Application to aortic, mitral and tricuspid valves]. / Substituts valvulaires humains dans le traitement des endocardites évolutives complexes. Application sur les orifices valvulaires aortiques, mitraux et tricuspides.

The aim of this study was to assess the immediate and long-term results of human valvular substitutes (homografts and autografts) in the treatment of complex progressive endocarditis in aortic, mitral and tricuspid valves. Since 1992, 80 patients (64 men, 16 women) aged 44 +/- 16 years (range 15 to 76 years), were treated. In 53 patients, the endocarditis involved native valves, 4 on previously plastified valves, or prosthetic valves in 27 patients. The endocarditis was recurrent 6 patients. The lesions were situated on the aortic valve (N = 59), mitral valve (N = 5), aortic and mitral valves (N = 12), aortic and tricuspid valves (N = 3), mitral and tricuspid valves (N = 1). The peroperative findings confirmed the lesions diagnosed at echocardiography: prosthetic valve dehiscence (27 patients), prosthetic cusp tear (N = 7), vegetations (N = 61), perforations (N = 48), periannular abscess (N = 47), aorto-ventricular discontinuity (N = 12), aorto-mitral discontinuity (N = 7), right ventricular aortic fistula (N = 1), aorto-pulmonary fistula (N = 1), pseudo-aneurysm (N = 1), ventricular septal defect (N = 1). Eighty-six human valvular substitutes were used (double homograft in 6 patients): aortic homograft (N = 63), pulmonary in the aortic position (N = 1), the mitral position (N = 12), of which 8 were in the mitral and 4 in the tricuspid position, pulmonary autograft (N = 10). Ten mitral valve repairs were performed on infected lesions. Associated procedures included mitral valve repair (N = 5), tricuspid valve repair (N = 1) for non-infarcted valve lesions, replacement of the ascending aorta (N = 2), the aortic arch (N = 1), coronary bypass surgery (N = 2) and one nephrectomy. The hospital mortality was 5% (4 patients). The causes of death were: infarction (N = 2), myocardial failure (N = 1) and multiorgan failure (N = 1). Four early reoperations were required for technical problems, none for endocarditis. Seventy-three of the 76 survivors were followed up for 43 +/- 24 months (range 1 to 84 months). Eight patients died during follow-up, but only 1 of cardiac causes (operation for recurrent endocarditis in a drug abuser). Seven operations were performed, 3 for technical problems or structural failure, 4 for recurrent endocarditis. At 5 years' follow-up, the survival was 81 +/- 5%; 88 +/- 6% of patients were free of endocarditis, 77 +/- 6% had no reoperation: no patient had thromboembolic complications. These results show that human valvular substitutes are adapted for the treatment of complex, progressive aortic, mitral and tricuspid valve endocarditis when techniques of valvular repair are no longer feasible.

[Myxoid liposarcoma of the mediastinum]. / Liposarcome myxoïde du médiastin.

We describe a mediastinal myxoid liposarcoma case in a 47-year-old woman who complained of dyspnea. This kind of tumor is rare and becomes symptomatic by compression on mediastinal structures, especially on the respiratory tract. These neoplasms are therefore often voluminous at the time the diagnosis is made. Histopathologic examination is always necessary as much for diagnosis as prognosis. Surgery, whether radical or palliative, obtain the best therapeutic survival results in myxoid liposarcoma of the mediastinum.

[Left ventricular reconstruction after excision of a large fibroma]. / Reconstruction ventriculaire gauche après exérèse d'un volumineux fibrome.

The authors report the case of a 15 year old boy with a large left ventricular fibroma discovered after a series of syncopal episodes due to obstruction to ejection. The first attempt to remove the fibroma in Columbia was only partially successful. In view of the risk of death associated with this type of tumour, it was decided to offer the patient complete excision after a full morphological and functional evaluation of myocardial function and the consequences of the tumour on mitral valve function and on the coronary circulation. The operation was performed under cardiopulmonary bypass and aortic clamping by conventional surgery, associated with reconstruction of the cardiac free wall with a large patch of autologous pericardium which was necessary to avoid cardiac transplantation, the ultimate sanction in this indication.

[Total colonic form of Hirschsprung disease. Treatment and long-term follow-up in 16 cases]. / Forme colique totale de la maladie de Hirschsprung. Traitement et suivi á long terme á propos de seize cas.

From 1971 to 1994, 16 cases of total colon Hirschsprung's disease were treated at the University Hospital in Rennes. Diagnosis have been at 2 days to 3 months. Two children had a family history of Hirschsprung disease among which one associated megacolon and multiple endocrine neoplasia. This family had a mutation of the RET proto oncogene. Six children died before complete surgical cure, among whom 4 before total parenteral nutrition. Six were treated according to Lester Martin, 3 according to Duhamel, and 1 to Swenson. Diarrhea and occlusions happened during the first postoperative years. None had any enterocolitis. Eight of 9 followed children are continent. Technique had no influence on long term outcome. Early neonatal occlusion management seems to decrease enterocolitis's incidence. We abandoned Lester's technique and kept Duhamel's technique. The problems encountered during ileostomy period do not encourage us to forward the age of definitive surgery procedure.

[Anesthesia programmed by enflurane]. / Anesthésie programmée à l'enflurane.

A microcomputer type 6502 is the central unity of a volatile anaesthetic injector for use in a closed circuit breathing system. Estimated calculations for quantity of anaesthetic liquid are done in agreement with the formula of J.W. Severinghaus and H. Lowe. Clinical assay is realised with enflurane. The syringe efficacy is controlled by permanent recorder of halogenate concentration in upper airways Fi-FA: infrared analysor cosma Rubis 3000).

Echocardiographic patterns in infants and children with chronic renal failure.

Sixty-five echocardiograms were performed on 20 children with chronic renal failure and were compared with 101 normal controls. The main cardiac abnormalities were dilation of left ventricle and left atrium, left ventricular wall and septum hypertrophy, increase of cardiac output, and rarely decrease of contractility. Anemia, arteriovenous fistula, arterial hypertension and severe renal failure (patients treated by maintenance dialysis) were factors associated with these abnormalities. The authors emphasize the value of echocardiograms in the follow up of children with chronic renal failure.

[Unidimensional echocardiogram of normal infants and children (author's transl)]. / L'échocardiogramme de l'enfant normal. Les paramètres de la fonction ventriculaire gauche.

One hundred and one echocardiograms were performed in children 8 days to 15 years old. The values measured were : end-diastolic and end-systolic left ventricular diameters, aortic root diameter, left atrial diameter, end-diastolic septal and posterior wall thickness, mitral valve excursion. There is a good correlation of these values with the square root surface area. The indices of left ventricular performance are : mean velocity of circumferential fiber shortening (correlated with heart rate), ejection fraction and shortening fraction. These indices are not correlated with body surface area. These data can be used in the echocardiographic investigation of infants or children with heart diseases.

[Bactericidal activity "in vitro" of sulfamethoxazol-tri-methoprime (SMZ-TMP) alone and in combination with various antibiotics on bacterial strains isolated from urinary tract infections (author's transl)]. / Activité antibactérienne du sulfaméthoxazol-triméthoprime (SMZ-TMP) seul ou associé a d'autres antibiotiques sur des bactéries isolées d'infections urinaires.

The authors study "in vitro" effects of sulfamethoxazol-trimethroprime (SMZ-TMP) on 1 078 bacterial strains isolated from urinary-tract infections during january 1974, the second trimester 1974 and january 1975. Study involves two parts : comparison between bacteriostatic activity of SMZ-TMP, ampicillin and nalidixic acid; evaluation of bactericidal activity of antibiotic associations including SMZ-TMP. MIC study included all strains. On Gram- negative bacilli the bacteriostatic activity of SMZ-TMP (74,6 percent of sensitive strains) was comparable with nalidixic acid (79,6 percent of sensitive strains) and better than ampicillin 31,4 percent of sensitive strains). On staphylococcus strains the bacteriostatic activity of SMZ-TMP (84,6 percent of sensitive strains) is better than ampicillin (36,4 percent of sensitive strains); on streptococcus strains the bacteriostatic activity of ampicillin (71 percent of sensitive strains) is better than SMZ-TMP (5l percent of sensitive strains). 473 associations including SMZ-TMP were studied upon 44 strains of Gram- negative bacilli by bactericidal test. ("Cross disposition" method, derive from "cellophane transfer method".

[Heatstroke among psychiatric patients under neuroleptic therapy. Apropos of 2 fatal cases]. / Coup de chaleur chez les malades psychiatriques sous traitement neuroleptique. A propos de deux cas mortels.

Heat stroke is uncommon in temperate climates but may be favourised by drug treatment. A report of two cases of fatal hyperthermia occuring in patients treated with neuroleptic drugs and during a heat wave is followed by a discussion of the characteristics which may be used to differentiate heat stroke from the hyperthermia of malignant twenty cases. It indicated that high degree of severity of this type of heat stroke, in great part related to the high prevalence of massive inhalation. The action of neuroleptics is very probably central by an effect upon the thermostat and also by changes in behaviour. The role of associated anti-parkinsonian agents is discussed. A review of treatment emphasises its difficulties.

[Influence of an hypolipemic agent on the incorporation of 14C-labelled precursors in hepatic and serous lipids of the rat]. / Influence dun hypolipémiant sur l'incorporation de précurseurs marqués par 14c dans les lipides hépatiques et sériques du rat

The action of a new hypolipidemic agent, the calcium diacetone-(ceto 2)-gulonate (D.C.G.Ca), on cholesterol and other lipid compounds biosynthesis has been studied in rats. The incorporation of 14C labelled acetate and mevalonate in liver and serum lipids of control rats has been compared with that of rats previously treated with D.C.G.Ca. No action of this compound has been noted on cholesterol biosynthesis after the mevalonate stage, which is an important result in consideration of therapeutic risks. Otherwise, a significant decrease of 14C-acetate incorporation in triglycerides has been observed in treated rats.